Spinal Surgery - Medical specialists

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Overview

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Spinal Surgery - Further information

Overview of cervical spine surgery

Cervical spinal fusion is a common type of cervical spine (neck) surgery that connects certain selected neck bones together. This can be achieved in a variety of ways:

  • bone can be taken from your body (an autograft) to form a bridge between neighbouring vertebrae in order to promote the growth of fresh bone
  • the above technique can be performed instead with bone from a bone bank (an allograft)
  • the fusion can be performed with entirely artificial material
  • the vertebrae can be held together with metal implants until fresh bone growth occurs
  • adjacent vertebrae can be connected via screwed metal plates
  • a vertebra can be removed to allow the spine to be fused
  • a spinal disc can be taken out to allow adjacent vertebrae to be fused

This procedure can be performed via an incision on the anterior (frontal) or posterior (rear) surface of the neck.

Who offers cervical spine surgery?

Cervical spine surgery is commonly offered by specialist private health clinics, which are in some cases managed by universities, insurers, mutual societies or religious institutions. In addition, there are state-run hospitals (such as those managed by the UK’s NHS or Germany’s Federal Ministry of Health), which also employ skilled surgeons who specialise in various kinds of cervical spine surgery.

What does cervical spine surgery help with?

Cervical spine surgery can help with the treatment of the following conditions:

  • after a neck injury, for example, to stabilise the neck structures and avoid the risk of a bone fracture causing further serious instability, or even spinal cord damage (which could threaten possible paralysis)
  • cases where neck vertebrae are misaligned

Cervical spine surgery can also be used as a follow-up surgical procedure in the case of:

  • spinal stenosis (narrowing of the spinal canal, which pinches nerves and is mostly due to ageing)
  • a herniated (bulging) disc between two vertebrae, which exerts pressure on the nerve root close by, causing pain and inflammation
  • treatment of spinal deformities
  • rheumatoid arthritis symptoms
  • spondylosis (degenerative disc disease) where the disc fluid dries out, resulting in tears in the annulus (fibrous ring surrounding a disc) and causing the nerve root to become inflamed
  • cervical spine infections
  • the removal of benign or malignant tumours

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When is cervical spine surgery used?

Cervical spine surgery is used to treat a variety of cervical spine problems, in many cases where a condition has failed to respond to more conservative treatments. In general, surgical procedures address degenerative disorders, trauma or instability problems. All of these conditions may bring pressure to bear on the spinal cord, or on the nerves that branch out from the spine and pass through the vertebrae on their way out to other parts of the body.

What are the risks of cervical spine surgery?

As with any other form of surgery, cervical spine surgery can involve certain risks including:

  • change of voice and difficulty swallowing (usually temporary) as a result of possible damage to the trachea (windpipe) and/or oesophagus (gullet)
  • excessive bleeding, which may require the insertion of a small drain
  • wound infections
  • DVT (deep vein thrombosis) due to blood clot in a leg
  • PE (pulmonary embolism) due to blood clot in a lung – a rare occurrence
  • nerve damage may cause numbness, and more rarely, disturb bladder and bowel functions
  • paralysis (extremely rare)
  • dural tear and leakage of spinal fluid (rare in cervical spine surgery)

Other possible complications include urinary retention and constipation (with no long-term implications in either case).

Any form of spinal surgery can be complex and the issue of ‘revision surgery’ (a further round of treatment) can arise – for example, to correct a deformity. Complications are a little more likely to occur, and it is often more difficult to achieve restoration of nerve functions via revision surgery.

Are there alternatives to cervical spine surgery?

Where neck pain is caused by a compression of the spinal cord, as in cervical spondylotic myelopathy (CSM), milder cases can sometimes respond to the following non-surgical treatment options:

  • a padded cervical collar worn around the neck can be used as a fairly temporary measure to rest the neck muscles and restrict painful neck movements
  • physical exercise therapy can reduce pain, develop flexibility and build stronger neck muscles
  • non-steroid, anti-inflammatory medications can be used for pain relief and to reduce inflammation
  • oral corticosteroids and narcotics can also be used for a limited period to relieve more severe pain

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